| NPI | 1841649845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IL 036148211) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125068221) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2021-08-13 |